The Indian Journal of Pediatrics

, Volume 85, Issue 12, pp 1086–1089 | Cite as

Agreement Between Integrated Management of Childhood Illness and Final Diagnosis in Acute Respiratory Tract Infections

  • Sıddika Songül Yalçın
  • Beril ÖzdemirEmail author
  • Sadriye Özdemir
  • Esra Baskın
Original Article



To evaluate the agreement between integrated management of childhood illness (IMCI) and final diagnosis in patients presenting with cough at the second and third level health institutions.


This cross-sectional study included 373 children aged 2–60 mo who presented with cough at the pediatric emergency and outpatient clinics in the Department of Pediatrics. After clinical examination of children, body temperature, respiratory rate, saturation, presence or absence of the chest indrawing, rales, wheezing and laryngeal stridor were recorded. Cases were categorized according to IMCI algorithm regarding the severity using the color code, such as red (urgent treatment), yellow (treatment in the hospital), or green (treatment at home). Final diagnosis after physical examination, laboratory analysis and chest X-ray was compared with the IMCI algorithm.


Study agreement between IMCI classification and final diagnosis was 74.3% with kappa value 0.55 (moderate agreement). Similar agreement values were detected in both the second and third level health institutions. Health condition and gender did not affect agreement value. Agreement were found to be high in patients <24 mo of age (ĸ = 0.67), presence of fever and cough (ĸ = 0.54), tachypnea (ĸ = 0.93), chest indrawing (ĸ = 1.00) and oxygen saturation of <94%(ĸ = 0.90).


Adding saturation level to the IMCI algorithmic diagnosis may increase agreement between IMCI classification and final diagnosis.


Integrated management of childhood illness Saturation Children Tachypnea Pneumonia 



SSY: Composed the theme of the manuscript; BÖ and SÖ: Collected the data of the patients and wrote the manuscript; EB: Collected the data of the patients. Dr. Kadriye Yurdakok, Department of Pediatrics, Unit of Social Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest



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Copyright information

© Dr. K C Chaudhuri Foundation 2018

Authors and Affiliations

  • Sıddika Songül Yalçın
    • 1
  • Beril Özdemir
    • 2
    Email author
  • Sadriye Özdemir
    • 3
  • Esra Baskın
    • 4
  1. 1.Department of Pediatrics, Unit of Social PediatricsHacettepe University Faculty of MedicineAnkaraTurkey
  2. 2.Department of PediatricsBaskent University Faculty of MedicineBahçelievlerTurkey
  3. 3.Department of PediatricsIlgın State HospitalKonyaTurkey
  4. 4.Department of Pediatric NephrologyBaskent University Faculty of MedicineAnkaraTurkey

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